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Having so many issues, need a ton of help VERY LONG

I feel at such a loss and overwhelmed over this whole breastfeeding thing and need some help and guidance.

My baby girl was born via emergency c-section 2 weeks early and weight 5lb5oz at birth. I wasn't allowed to have skin to skin right away as she was whisked away to be cleaned and poked and prodded. I didn't get to see her until 2 hours after birth at which point we attempted breastfeeding. My left nipple is inverted and my right is flat but bigger than the left.

Breastfeeding was a struggle from the get-go and I saw three different LCs at the hospital before I left. Each one helped me out and feeding her was a little bit better each time but it's still a huge struggle. I was taught the football hold because of my c-section incisions. I was given a nipple shield to use during feeding and shells to wear the rest of the time and told to pump at every other feeding. Because of her small size they told me to wake her every 2 hours to feed her, which I did. Towards the middle of her second week, she started sleeping for 4 hours at a stretch and would not be roused awake. Even when I tried waking her up at 2-3 hours she would just fall asleep the second her head was by my breast so I just began letting her sleep and having her tell me when she was hungry.

I tried on demand feeding but her cues weren't great. She would sleep, then as soon as she woke up she would start crying (a hunger cry I would assume) so I would change her diaper right away (as she never cries with a soiled diaper so I always have to check when she wakes up) and then breastfeed her. I hated the nipple shield so I tried it once in the middle of the night without it and she was able to latch so I decided to give it up.

The struggle we were having then was she refused to stay latched. I would put the nipple in her mouth, she would suck once, push it away with her hand while pulling her head back, start crying and then open her mouth again to indicate hunger. This would happen for a long time until she finally latched or I gave up in frustration. And sometimes when feeding she would also fall asleep in the middle which was when I would say "all done" and put her to sleep. Some of those feedings didn't take very long either...at the shortest 4 minutes and the longest 13 minutes. But I was concerned she wasn't eating enough so I called a private LC who does house calls.

After her evaluation she told me to use the nipple shield for 5 mins in the beginning and then latch her off the shield and onto my nipple. She also told me to "wake" her in the middle of feedings by doing baby crunches and not to just take her falling asleep as her being done because she wasn't at such short feedings. I did get reassurance she was eating though because she had gained weight since her last weight at the pediatricians.

Our feedings were going slightly better but still not great. We had less problems with her latching off continuously (except for an hour battle yesterday with both of us in tears...) and she seemed to be feeding for 20 or more minutes at a stretch but usually 15 minutes. She still was sleeping 4 hours at night and sometimes 3 during the day which the LC said was fine and not to wake her just to feed. She also is having a ton of wet diapers and pooping a lot too so that was another sign she was eating well.

So I tried doing the shield in the beginning and then switching to the bare nipple. It worked a couple of times. But for the most part, as soon as I took it off and gave her my nipple she would just leave it in her mouth and fall asleep even though she was sucking on the shield. So now I try just the bare nipple first to see if she will take it and most times she will. The other problem I am having now is she stops sucking and I feel like she doesn't/can't get into a rhythm. I have to do either compressions with my thumb or gently nudge her under her chin (which is what the LC told me to do) to get her going again. Other times I will put the bare nipple in her mouth and she just stares at me and doesn't do anything. But usually she doesn't have her eyes open once she gets going, she will suck with her eyes closed but she is awake.

Yesterday I also noticed that when my nipple came out of her mouth, it looked flattened. I have very large areolas and very large breasts (was a 38/40 DD before and haven't been measured since but assume it has gone up at least 2 cup sizes because they look mammoth) and I cannot really see how much of the areola she has in her mouth because when I try to lift the breast to check it usually moves in her mouth and I don't get an accurate view. So now I am convinced she isn't latched correctly. However, I do not have pain, just the initial latch but after that it's fine.

Another weird thing she does is sometimes she will breathe very loudly with the nipple in her mouth without sucking and will let out a wheeze. Does that mean I am suffocating her or is that normal? It just sounds scary.

Last night she actually fed on the right breast for almost 30 minutes. As soon as I picked her up and was about to lay her down on the changing table to change her diaper she spit up and it came out her nose and mouth. I got so scared! She has spit up a couple of times before, not really sure what triggers it as the feedings weren't long then, and the pediatrician assured me that spitting up was normal but it makes me feel so bad as I spent all that time feeding her and now it's gone to waste.

Yesterday we had our follow-up phone call and the LC also told me to not to sleep with my shells in as they could cause blocked ducts depending on how I slept. I tried it last night and when it was feeding time, even with the shield, I was in A LOT of pain! My nipples also looked like they went back to "normal" (ie. before I started wearing the shells to draw them out). So I ended up putting them back in.

Thank you to anybody that can help me out or offer any guidance because I am getting to a point where I dread feedings and that is not what I should be feeling. I should be bonding. I love her so very much and only want what's best (which is breastfeeding) and really don't want to give up but with all the problems we are having I am not able to enjoy my time with her. As it is all she does is sleep and eat. She has very few awake moments during the day when she's not feeding so I get no play time with her. Sometimes I will lay her on my chest after a feeding just to have some time bonding.

Re: Having so many issues, need a ton of help VERY LONG

Mama - I think you might have a touch of oversupply! If your baby is gaining weight, peeing and pooping all the time - everything is great! Just because you think, or the book thinks, or the LC thinks that she shouldn't be full after 13 minutes, doesn't mean that she isn't. I don't know much about shells, but if they weren't hurting you, and were helping - then you should use them.

Re: Having so many issues, need a ton of help VERY LONG

I agree, it sounds like oversupply. She is probably having a hard time keeping up with the fast flow. If you can feel your letdown, take her off when it starts and let the milk flow out into something or into a clean cloth. Once it slows down try to latch her again. Or you can pump out a bit before feeding her so that it doesn't come out too fast. I have had the same problems with huge spit ups. This may be because you have a foremilk/hindmilk imbalance. Here is more info on it: http://www.breastfeeding-problems.co...imbalance.html
You need to make sure she "empties" one side in order to ensure that she gets the hindmilk. Try nursing one side per feeding to enable her to get to the hindmilk. If she gets a good amount of hindmilk she will be less gassy and fussy from tummy problems. The pooping and peeing and gaining weight is good, but she still needs that hindmilk!! Also, if you pump some out before you nurse this will get rid of some of the foremilk and she won't fill up too much from it.
All the best! Keep at it, it will get better. If you need to, have someone come and help! Hugs to you.

Re: Having so many issues, need a ton of help VERY LONG

Sounds like you have a lot going on! So sorry you are dealing with so much right now. It can be so hard to try and adjust to having a baby and then learning to breastfeed. You are both new at it, so that in itself is a struggle. Since she was born early, she may tire more easily at the breast than a full term baby. The fact that she fed for 30 min is a huge accomplishment! If the shells aren't working for you, then don't use them. As she gets bigger, she will get stronger and pulling the nipple out more will not be so much of an issue. You are doing one of the best things you can for her though, which is skin to skin. Doing that A LOT will help her learn to breastfeed well. They have even done studies and found that babies who were even months old were able to latch on after doing a lot of skin to skin contact. She will learn to breastfeed, but it will take time and committment on your part. If there is a way you can wear her around so she has constant access to your breasts, that would be ideal. Her making weird noises can be normal, but if you notice her nose is being blocked in some way, you can adjust her. The laid back position is great for women with a fast flow and oversupply. If she gets fussy when you try to latch, maybe she is just impatient, try pumping to get the flow going before you latch and see how she does.

Re: Having so many issues, need a ton of help VERY LONG

Relax, mama- as long as baby is peeing and pooping and gaining weight, and you are not in severe or lasting pain when nursing, everything you describe sounds on the good side of normal!

Fast feedings: normal, as long as baby has good diaper output and weight gain. Feeding duration varies widely even among very young babies, with some taking close to an hour to nurse, and others capable of getting a full meal in just 5-10 minutes

Unlatching in the middle of a feeding: common, especially when mom has a fast letdown. It can be baby's way of coping with a rapid milk flow, or it can be baby's way of protesting that the flow has slowed down. Either way, just offer the breast again.

Shield use: not a problem as long as baby continues to have the right number of wet and poopy diapers and good weight gain. But if the baby will take the breast without the shield, definitely offer without! The 2 problems with shields are that they can in some instances impede milk transfer, and that babies often become very attached to them and won't nurse withoutnthem, which can be inconvenient (particularly in public).

Flattened nipples after baby unlatches: not a problem provided that nursing is generally pain-free and diaper output and weight gain are good. Flattened nips are a sign of a less-than-ideal latch, but if the latch feels good, it generally is good.

Loud breathing and wheezing while nursing: normal, particularly if baby is experiencing a fast flow of milk. If you had to breathe only thorough your nose while drinking from a very fast-flowing hose, you'd make all sorts of whacky sounds, too! My second daughter sounded like a squeaky door when she nursed.

Spit-up: normal. The muscle sphincters which keep stomach contents down where they belong are weak in new babies, and something as simple as a position change can often provoke baby's meal to shoot back up. As long as baby is gaining weight, the spit-up is not projectile (literally flying across the room), and the spit-up is produced without evidence of pain, then this is a laundry issue, not a health issue. Don't worry that a big spit-up means that all the baby's meal was "wasted"- spit-up may look copious but it's usually only a small portion of what baby had in her tummy. The average feeding is around 2-3 oz, and if you were to pour 2-3 oz of cow's milk out on the counter you would see that it looks like a much bigger amount than it really is.

Shells at night: if you are not experiencing frequent plugs, not a problem.

Finally, I totally get that breastfeeding so far has not been the delightful bonding experience that you probably envisioned while pregnant. This is NORMAL. Nursing a new baby is not fun for most mommies. New babies pretty much only eat, cry, sleep, and poop. They don't coo, giggle, smile, or reach out with a tender touch. They require a lot of assistance with positioning, may cause mom pain while nursing, and often feed for long and draining time periods. But please be assured that bonding is going on, at its most fundamental level. You are learning baby's cues, and baby is learning what cues work, and most importantly, she is learning to turn to you as her main source of comfort and nutrition. It takes a while to get that foundation set in place. But once it's there, you will build a wonderful nursing relationship on top of it!

Re: Having so many issues, need a ton of help VERY LONG

Originally Posted by @llli*esmomof3

If you can feel your letdown, take her off when it starts and let the milk flow out into something or into a clean cloth. Once it slows down try to latch her again. Or you can pump out a bit before feeding her so that it doesn't come out too fast.

These things can work very well for some mamas and they are certainly worth trying, but my baby did not have the patience for any of it. Nursing reclined was the only thing that help with my crazy milk spray. I leaned back on a few pillows, put my baby on my chest or stomach, and let him latch. It took a lot of adjusting the positioning to find something that worked for us, but once I did it saved our nursing relationship. This laid back positioning can help with lots of latch issues even if your problem is not related to oversupply or a fast letdown, so I really think it is worth a try.

Nursing reclined and nursing on one breast per feeding helped a little with the spit up, but my son still spewed spit up like a fountain. Spit up comes along with oversupply and overactive letdown (but is not necessarily related to a foremilk/hindmilk imbalance) and is nothing to worry about unless there is pain involved. If weight gain and diaper output are good (and it sounds like they are ), then your baby is getting enough milk regardless of the spit up.

with mommy2lilah. It doesn't matter when anyone else thinks your daughter should be full, she knows better than any of them. My son was a fast nurser too, he spit up a ton, and he was an extremely fat and healthy little baby.

Re: Having so many issues, need a ton of help VERY LONG

thank you to everyone's encouragement and kind words.

The problem is that I don't know when I let down, I don't have any kind of tingling feeling or anything, they just feel the same. My breasts also don't feel much different before a feeding than after so I can't really tell when she has "drained" one side. She also doesn't always swallow, but she will suck on one side for awhile before I hear any swallowing. I almost feel like she has a problem getting into a rhythm. So do I even count just the sucking part of her feed for timing reasons? Ie. she started at 8am initially to latch and we spent 30 minutes on one side versus she started her latch at 8am and kept coming on and off but really started the suck-swallow pattern at 8:15am and stopped at 8:30am so she only really ate for 15 minutes. When I do the hand compression while she is latched, I will sometimes hear a HUGE swallow, not the "ca-ca" sound.

Right now I have pretty much decided to give up on the shield because even after the 5 minutes on it, after I latch her off of it and onto my own nipple, she either falls asleep with it in her mouth or keeps latching off. So I have been doing without. She does latch, but she will either not suck or do anything, or suck but not swallow, or push it out of her mouth and start screaming. Doesn't this all sound like a slow let down versus a fast one?

I have PCOS, so I am lucky to even have milk come in (that was my biggest worry, didn't think I would even have issues actually feeding) and when I pump every other feed I get 100 ml from each side at the most in the mornings and in the evening about 50 ml.

A lot of times, when I think we are done feeding, I go change her diaper, put her down in wherever she is sleeping at the moment (upstairs is a pack and play newborn napper, downstairs is the snugabunny rock and play) and as soon as I lay her down she starts opening her mouth as if to indicate hunger and sucks on either her hand or her shirt collar. We had this issue last night and she barely swallowed anything on one side then she fell asleep and when I put her down she did that and then started crying until I picked her up. So we tried nursing again and she still didn't really do anything. But she does seem to want to nurse because as soon as she pushes my breast out of her mouth she opens it and tries to shove it in with her hand. If it wasn't so frustrating it would be very cute.

Re: Having so many issues, need a ton of help VERY LONG

Originally Posted by @llli*jadedfrrog

. So do I even count just the sucking part of her feed for timing reasons? Ie. she started at 8am initially to latch and we spent 30 minutes on one side versus she started her latch at 8am and kept coming on and off but really started the suck-swallow pattern at 8:15am and stopped at 8:30am so she only really ate for 15 minutes. When I do the hand compression while she is latched, I will sometimes hear a HUGE swallow, not the "ca-ca" sound.

hi mama! stop watching the clock. seriously. just watch your baby. stop timing everything and look to her for cues that she's had enough - output and weight gain, satisfaction, milk-drunk, and sleeping.

Right now I have pretty much decided to give up on the shield because even after the 5 minutes on it, after I latch her off of it and onto my own nipple, she either falls asleep with it in her mouth or keeps latching off. So I have been doing without.

good - if she will latch without the shield, better to ditch it.

when I pump every other feed I get 100 ml from each side at the most in the mornings and in the evening about 50 ml.

wait, 100 ml like 3 oz from EACH side in the morning, in addition to feedings? most mamas get 3 ozs TOTAL per pump, so you are an overachiever this, too, points to oversupply, which explains why your DD doesn't want to nurse for very long. why are you pumping? it can exacerbate the oversupply, especially this early (your DD is still like 2 weeks old, right?)

A lot of times, when I think we are done feeding, I go change her diaper, put her down in wherever she is sleeping at the moment (upstairs is a pack and play newborn napper, downstairs is the snugabunny rock and play) and as soon as I lay her down she starts opening her mouth as if to indicate hunger and sucks on either her hand or her shirt collar.

this is normal for young babies. they need to eat very frequently, and if you have oversupply, eating all. the. time. is good for both of you.

hang in there, mama. your life right now is just nursing. that's how it's supposed to be.

oh also maybe when she wakes you should try nursing first before diaper change, then when there's a pause in the nursing try to change her diaper and offer to nurse again.

Re: Having so many issues, need a ton of help VERY LONG

My concern really isn't watching the clock per se but more like I don't want to assume she's all done (she almost always falls asleep while nursing even if it's just for 3 minutes so I can't really use that as to gauge her hunger) just because she was sucking but not swallowing. Although DH said that she must be getting something from just the sucking but I always thought you had to hear the "ca-ca" sound to make sure she was eating. She always gets roused awake during diaper changes and always seems to fuss when we try to put a clean one on. For some reason she's content sitting in a dirty one, I will never understand that.

The right one usually gives me more. It will average 100 ml (like 3.3 oz) in the mornings and taper off to 50 ml in the afternoon and evening. The left one has done 100 ml before but usually will do around 70-80ml in the mornings then taper off to 40-50 ml in the afternoon and evening. So total I have gotten as much as 180ml (8 oz) from a pumping session and at the lowest 90 ml (3 oz). They had me start pumping at the hospital because of my PCOS and they wanted to make sure my milk came in because she wasn't nursing well and I was barely making colustrum. They said they were "tricking" my body into thinking I had more than one. I actually saw 3 different LCs during my 4 day c-section recovery and the first one had me pump every feed then she switched me to every other feed. She also kept losing weight continuously the first 2 days and was jaundiced. She lost 5 oz over 3 days and the day before discharge she had gained 1 oz. She was born 2 weeks premature so they were very concerned. She is actually 2.5 weeks old, will be 3 weeks on sunday.

But sometimes she will go 4 hours without eating too...she will just sleep and that does worry me somewhat since all I can think of is she only nursed for 8 minutes, how is she not hungry???